2018년 10월 22일 월요일

[ ] [CK] Supratherapeutic INR

https://evidencebasedpractice.osumc.edu/Documents/Guidelines/Warfarin.pdf

In most cases, if the dosage needs to be adjusted, then it should be adjusted by 5% to 20% of the total weekly dose,17 depending on the current INR, the previous dose, and any changes identified that may have been reasonable.

5% ~ 20% (likely 10% in a week.)
7.5 -> 7mg qd: reasonable.
more
7.5 -> 6mg qd: maximum.

https://my.clevelandclinic.org/ccf/media/Files/anticoagulation-clinics/practical-tips-for-warfarin-dosing-and-monitoring.pdf

skip 1-2 doses per recheck INR 1-2days(maybe 24-48hrs; drop - resume, still high - hold one more)

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